Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 062494 | GA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 062494 | GA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 062494 | GA |
NPI | 1053518423 |
---|---|
Provider Name | Dr. Sima Dehghany |
First Address | Roswell, GA 30076-8224 |
Second Address | Roswell, GA 30076-1230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 03/10/2019 |